Publications by authors named "Shaida Varnous"
Background: Long-term clinical outcomes of early intravascular ultrasound (IVUS) findings in a prospective cohort of heart transplantation (HTx) patients have not been evaluated.
Methods: This study included patients from 20 centers across Europe and North and South America among the original cohort of the RAD B253 study. Among these patients, 91 had paired IVUS images at baseline and 1-year post-transplant: everolimus 1.
Objectives: This study aimed to identify perioperative risk factors of acute kidney injury after heart transplantation and to evaluate 1-year clinical outcomes.
Design: A retrospective single-center cohort study.
Setting: At a university hospital.
Objectives: Heart transplantation (HT) is the only life-extending therapy in adults with congenital heart disease (CHD) and end-stage heart failure. HT is considered at high risk in complex CHD given the anatomical complexity and past medical history. Little is known about long-term outcomes after HT in these patients.
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- - Legionnaires' disease (LD) is a serious infection particularly affecting solid organ transplant recipients, though details about its impact on this group have not been well documented.
- - A 10-year study in France identified 101 patients with LD among transplant recipients, finding that severe cases were linked to factors like negative urinary antigen tests and respiratory symptoms.
- - Key imaging results showed significant lung involvement, and the study reported a 30-day mortality rate of 8% and a 12-month mortality rate of 20% among these patients.
Aims: The epidemiology of sudden cardiac death (SCD) after heart transplantation (HTx) remains imprecisely described. We aimed to assess the incidence and determinants of SCD in a large cohort of HTx recipients, compared with the general population.
Methods And Results: Consecutive HTx recipients (n = 1246, 2 centres) transplanted between 2004 and 2016 were included.
Background: The 2018 World Symposium on Pulmonary Hypertension (WSPH) changed the definition of pulmonary hypertension (PH) with a new threshold of mean pulmonary artery pressure (mPAP) above 20 mmHg.
Objective: To evaluate the profile and prognosis of patients with chronic heart failure (HF) considered for heart transplantation with the new definition of PH.
Methods: Patients with chronic HF considered for heart transplantation were classified as mPAP, mPAP , and mPAP.
Association between vasoactive-inotropic score, morbidity and mortality after heart transplantation.
Interdiscip Cardiovasc Thorac Surg
April 2023
Objectives: The aim of this study was to evaluate the association between vasoactive-inotropic score (VIS), calculated in the 24 h after heart transplantation, and post-transplant mortality and morbidity.
Methods: This was an observational single-centre retrospective study. Patients admitted to surgical intensive care unit after transplantation, between January 2015 and December 2018, were reviewed consecutively.
Background: In 2018, a cardiac allocation scheme based on an individual score considering the risk of death both on the waitlist and after heart transplantation was implemented in France.
Aims: To analyse the practical application of the pre- and post-transplant risk score in a French high-volume heart transplantation centre.
Methods: All consecutive adult patients listed for a first non-combined heart transplantation between 02 January 2018 and 30 June 2022 at our centre were included.
Article Synopsis
- The SARS-CoV-2 Omicron variant was first detected in France in mid-November 2021, with a surge in cases starting in early December and peaking in mid-January 2022, but it had a lower fatality rate than earlier waves.
- A study investigated the incidence and mortality rates of COVID-19 among the general population and 1,263 heart transplant recipients from June 2021 to February 2022, focusing on the differences between Omicron and Delta variant infections.
- Contrary to expectations, the study found that the severity of Omicron variant infections in heart transplant recipients did not align with its generally lower severity in immunocompetent individuals.
Article Synopsis
- In 2018, France introduced a new cardiac allograft allocation scheme to assess the risk of death for patients on the waiting list and after heart transplants.
- A study at La Pitié-Salpêtrière Hospital analyzed data from 2012 to 2021, involving 1098 candidates and 855 transplant recipients, comparing outcomes before and after the new scheme's implementation.
- The update led to a decrease in candidates on inotropes and an increase in patients with worse kidney function and more severe conditions undergoing transplantation, yet overall post-transplant outcomes remained unchanged.
Background: Few data exist on the characteristics and outcomes of patients with arrhythmogenic right ventricular cardiomyopathy and advanced heart failure who undergo heart transplantation.
Aim: To explore the pretransplant course and outcomes of patients with arrhythmogenic right ventricular cardiomyopathy after heart transplantation.
Methods: This observational retrospective monocentric study included all consecutive patients with arrhythmogenic right ventricular cardiomyopathy who underwent heart transplantation during a 13-year period (2006-2019) at Pitié-Salpêtrière University Hospital (Paris).
Background: In heart transplantation, antibody-mediated rejection (AMR) is a major contributor to patient morbidity and mortality. Multiple routine endomyocardial biopsies (EMB) remain the gold standard to detect AMR, but this invasive procedure suffers from many limitations. We aimed to develop and validate an AMR risk model to improve individual risk stratification of AMR.
View Article and Find Full Text PDFBackground: To evaluate the association between donors' and recipients' serum levels of soluble ST2 (sST2) and recipients' outcome after heart transplantation (HT).
Methods: Blood samples were collected in 50 heart donors before organ procurement and in 50 recipients before HT (D0), a week after HT (D7) and at every first year's endomyocardial biopsy (EMB); sST2 levels were evaluated by ELISA.
Results: Donors who sustained a cardiac arrest, had significantly higher sST2 levels.
Background: Sensitized patients, i.e. recipients with preformed donor-specific HLA antibodies (pfDSA), are at high-risk of developing antibody-mediated rejections (AMR) and dying after heart transplantation (HTx).
View Article and Find Full Text PDFA low anti-spike antibody response of 28.6% was observed 28 days after BNT162b2 vaccine second dose among 133 solid organ transplant recipients without previous coronavirus disease 2019 (COVID-19). No serious adverse events were recorded.
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- A case series study involving 39 heart transplant recipients in France showed that 89.7% required hospitalization due to COVID-19, with nearly 36% needing intensive care.
- A significant portion of patients (74.4%) had their immunosuppressive medications reduced or stopped, leading to increased complications.
- The study indicated a 56% higher mortality rate in heart transplant patients during the COVID-19 pandemic compared to the previous year, with pre-existing conditions like diabetes and chronic kidney disease further raising the risk of death.
Background: Cytomegalovirus (CMV) infection remains a common complication after heart transplantation (HTx). The association between CMV infection and allograft rejection is debated in the era of efficient prophylactic antiviral therapies.
Methods: This single-center cohort study utilized a highly phenotyped database of HTx recipients (2012-2016).
Allosensitization represents a major barrier to heart transplantation (HTx). We assessed the efficacy and safety of complement inhibition at transplant in highly sensitized heart transplant recipients. We performed a single-center, single-arm, open-label trial (NCT02013037).
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- - The study evaluated outcomes of heart transplants from marginal (MDs) versus optimal donors (ODs) based on patient records from 2004 to 2014.
- - Recipients of ODs experienced lower rates of primary graft dysfunction (PGD) and acute renal failure, along with higher survival rates compared to those receiving MDs.
- - The findings indicate that using MDs is linked to increased complications and lower short-term survival, highlighting the risks associated with these donor hearts.
Article Synopsis
- The study focuses on cardiac allograft vasculopathy (CAV), a significant cause of mortality in heart transplant patients, aiming to identify different progression patterns of CAV and the factors influencing these trajectories.
- Researchers monitored 1,301 heart transplant recipients from multiple academic centers, analyzing numerous angiographies and medical parameters to forecast CAV development and its association with patient mortality.
- Four distinct CAV progression profiles were discovered: no CAV progression, late-onset slow progression, mild progression, and accelerated progression, with specific early predictors identified that could help in understanding and managing CAV in patients.
Article Synopsis
- Heart transplantation outcomes were analyzed for patients supported by venoarterial extracorporeal membrane oxygenation (ECMO) versus those who were not, focusing on overall survival rates post-transplant.
- A study conducted at a high-volume center included 415 patients, with 118 (28.4%) on ECMO prior to transplantation; the median follow-up time was 20.7 months.
- Results showed no significant difference in 1-year survival rates between patients on ECMO (85.5%) compared to those without ECMO (80.7%), while donor-related factors influenced overall mortality independent of ECMO support.
After heart transplant, adding everolimus (EVL) to standard immunosuppressive regimen mostly relies on converting calcineurin inhibitors (CNIs) into EVL. The aim of this study was to describe the effects of combining low-dose EVL and CNIs in maintenance immunosuppression regimen (quadritherapy) and compare it with standard tritherapy associating standard-dose CNIs, mycophenolate mofetil, and corticosteroids. In the 3-year registry cohort of heart transplanted patients, those who received quadritherapy were compared with those who received tritherapy.
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